Celebrity Factor Leading to Insurance Bias? Doctors' body moves IRDAI over Saif Ali Khan's mediclaim cover

Mumbai: Expressing concerns about possible bias by an Insurance company that sanctioned Rs 25 lakh for the cashless treatment of actor Saif Ali Khan for his recent treatment at Lilavati Hospital, a doctors' body has written to the Insurance Regulatory and Development Authority of India (IRDAI) and demanded an investigation.

The Association of Medical Consultants (AMC) expressed concern over the fact that Saif Ali Khan was possibly given "preferential treatment" by the insurance company, compared to the benefits available to the common policyholders.

In its letter directed to the Chairman of IRDAI, the association has requested to investigate the incident and ensure that all policyholders, regardless of their social status, are treated equally. The association has also urged the Regulatory Body to implement strict guidelines to prevent such preferential treatment in the future and enhance transparency in the sanctioning process of cashless treatments to restore trust among the common citizens.

The shocking news of Khan recently being attacked by an intruder in his residence made headlines. The incident unfolded at Saif Ali Khan's residence in the 'Satguru Sharan' building in Bandra after an intruder allegedly confronted Khan's maid. When Saif attempted to intervene and de-escalate the situation, the confrontation turned physical. The actor sustained injuries during the scuffle and was rushed to Lilavati Hospital for treatment.

Medical Dialogues had earlier reported that the actor was treated at Lilavati Hospital, Mumbai and the doctors at the hospital informed that Khan sustained at least 6 injuries after the attack on early morning on January 16. A surgery was performed to remove a 2.5-inch-long knife lodged in his spine, and his leaking spinal fluid was also repaired.

However, the news of the actor being attacked and being treated at the hospital soon turned into a controversy after Khan's health insurance claim documents were leaked. Soon, the document started circulating on social media platforms with users pointing out how for the treatment of Khan at Lilavati Hospital, Niva Bupa Health Insurance Company approved Rs 25 lakh within hours! On behalf of the actor, a claim of Rs 35,95,700 was raised.

Now, raising the issue, the Association of Medical Consultants (AMC) Mumbai wrote to IRDAI expressing concern and dissatisfaction over the 'preferential treatment' given to Khan, pointing out how the actor was sanctioned 25 lakhs for cashless treatment under his insurance policy.

The association, which represents Specialist Medical Practitioners practicing in Mumbai and adjoining areas, mentioned in its letter directed to IRDAI, "This instance highlights a troubling trend where celebrities and high-profile individuals and patients with corporate policies receive favorable terms and higher cashless treatment limits, while ordinary citizens struggle with insufficient coverage and low reimbursement rates. Such practices create an unfair disparity and undermine the very principle of equitable healthcare access, which should be the cornerstone of insurance services."

"We believe Insurance should be a safeguard for all, irrespective of social status. Preferential treatment based on celebrity status creates a two-tier system, which is discriminatory against ordinary policyholders. There is a need for greater transparency in how insurance claims and cashless treatment limits are determined. Equal access to healthcare benefits should be a priority, with fair policies applied across all policyholders," it added.

Requesting IRDAI to investigate the issue and ensure equal treatment for all policyholders, the association also highlighted how there is an existing significant disparity in the payment rates offered by insurance companies to small hospital/ nursing homes compared to those extended to large corporate hospitals.

"While we understand the rationale of negotiated rates based on volumes and services, the current structure places small hospitals/nursing homes at a severe disadvantage, thereby impacting our sustainability and ability to provide continued care," it added in the letter.

Also Read: Saif Ali Khan Stabbed 6 Times: Lilavati doctors remove 2.5-inch knife from spine, Repair Leaking Spinal Fluid